More salt in food, but should we take recommended limits with a grain of skepticism?

Bob Fila, Chicago Tribune

Bob Fila, Chicago Tribune

Janice Neumann, Special to the Tribune

While many doctors urge patients to curb their sodium intake for better health, the processed food and restaurant industries continue to spike products with large amounts of sodium, according to a recent study.

The Dietary Guidelines for Americans in 2010 advised middle-aged or older adults, African-Americans and people with hypertension, diabetes mellitus or chronic kidney disease consume no more than 1,500 milligrams of sodium daily, and others 2 years and older to stay below 2,300 milligrams. The American Heart Association recommends that Americans 2 years or older eat no more than 1,500 milligrams of sodium. But the average American consumes about 3,300 milligrams of sodium daily, according to the U.S. Centers for Disease Control and Prevention.

The study, which was published in the May issue of the Journal of the American Medical Association (JAMA) pointed out that 80 percent of the daily sodium intake comes from processed or restaurant foods, making the recommended sodium levels near impossible unless people cook their meals from scratch.

Researchers examined the sodium content in popular foods from several major grocers, as well as fast-food restaurants, in a 2005 survey, which was repeated in 2008 and 2011. They found that from 2005 to 2011, the sodium content in processed foods decreased by 3.5 percent, and for restaurant foods it increased by 2.4 percent.

Dr. Stephen Havas, corresponding author of the study, noted studies have shown ingesting more than 1,500 milligrams of sodium daily increases blood pressure, which, if too high, can lead to heart disease, stroke and death. He said governmental regulation was needed to force the industry to lower the sodium content by at least 50 percent during the next 10 years.

The excessive use of sodium "allows them to use foods which may not be as high quality because it masks the taste," said Havas, research professor of preventive medicine at Northwestern University's Feinberg School of Medicine, about the industry's possible motives. "Salt is cheaper than using other spices that are healthy."

Havas also said saltier foods worked in their favor by making people drink more beverages.

"There's a profit motive that is huge," said Havas, who called on the American public to demand change.

But some doctors say the sodium recommendations are a bit too stringent and point to a recent study by the Institute of Medicine that found no health benefit from limiting daily sodium intake to no more than 1,500 milligrams if followed by high-risk individuals. The Institute of Medicine analysis supported the health benefits of limiting daily sodium intake to no more than 2,300 milligrams.

Dr. George Bakris, who directs the ASH Comprehensive Hypertension Center at the University of Chicago, called the JAMA study "reasonably well done," but thought the recent Institute of Medicine's suggestions were more appropriate. He suggested a government incentive program with tax breaks for reducing salt content by at least 10 percent to 20 percent .

"I think mandating it is just going to be aggravating and viewed as Big Brother has his nose in my business," said Bakris, also professor of medicine at the university.

Morton Satin, vice president of science and research at the Salt Institute (a nonprofit trade association that advocates for salt), said the Institute of Medicine study showed that previous salt recommendations were not correct.

"The problem is that these (former) recommendations have been with us for so long that we now believe they are based on fact, but they are not," Satin said in an email.

Havas, however, criticized the Institute of Medicine's findings as "fundamentally flawed, with conclusions that cannot be justified based on the available scientific evidence."